[Multiple myeloma predominantly involving the spleen].

Extramedullary disease is an uncommon manifestation in multiple myeloma (MM) and can be observed at onset or develop at disease progression or relapse. Splenic involvement is very rare. The paper describes a 52-year-old female patient with MM who in 1990 was diagnosed with monoclonal gammopathy of undetermined significance with IgGkappa secretion and a considerably enlarged spleen.

[Neurosurgical treatment for chronic subdural hematoma in a patient with chronic autoimmune thrombocytopenic purpura].

Intracranial hemorrhage in patients with chronic autoimmune thrombocytopenic purpura (CATP) is a rare and severe complication of the disease. By taking into account a concomitance of chronic subdural hematoma (CSH) and CATP and no generally accepted approaches to managing the patients with this concomitance, the authors describe a clinical case of mini-invasive CSH drainage in a patient with CATP.

[Ways of optimization in teaching of internal diseases in a medical institute].

A method of practical clinical games (PCG) performing is represented. For the PCG themes the extreme and urgent situations requiring the doctors of various specialities (especially on the cardiology and hematology cycles) are selected. A model of specific clinical situation, where students play roles, corresponding to the duties of speciality under conditions, maximally approximating to reality, is reproduced.